Search results for " leukoencephalopathy"

Reversible posterior leukoencephalopathy syndrome in a patient with thrombotic thrombocytopenic purpura

2011

Thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder characterised by fever, microangiopathic haemolytic anaemia, renal insufficiency, and thrombocytopenia. Neurological involvement, a prominent component of TTP, is characterised by a variety of brain lesions which include reversible cerebral oedema or magnetic resonance imaging (MRI) features of reversible posterior leukoencephalopathy syndrome (RPLS). TTP is frequently associated with deficiency of the von Willebrand factor-cleaving protease, ADAMTS13.Here, we report a case of TTP with severe acute encephalopathy. Posterior leukoencephalopathy and brainstem oedema with triventricular hydrocephalus were observed on MRI. The …

No evidence of beneficial effects of plasmapheresis in natalizumab-associated PML

2017

Objective:To examine retrospectively the effects of plasmapheresis (PLEX) on the survival and clinical outcomes of patients with multiple sclerosis (MS) and natalizumab (NTZ)–associated progressive multifocal leukoencephalopathy (PML).Methods:The medical literature was searched for the terms natalizumab and progressive multifocal leukoencephalopathy. A total of 193 international and 34 Italian NTZ-PML cases were included. Clinical outcome was determined by comparing the patients' clinical status at PML diagnosis with status after PML resolution. The effects on survival and clinical outcome of PLEX, sex, age, country, pre-PML Expanded Disability Status Scale score, NTZ infusion number, prior…

Four cases of progressive multifocal leukoencephalopathy in iatrogenic immunocompromised patients

2020

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by John Cunningham Virus (JCV). We report four PML cases in immunocompromised patients, respectively treated with (1) Natalizumab, (2) Rituximab, (3) autologous stem-cell transplantation, and (4) Tacrolimus. All patients underwent neurological examination, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), JCV-DNA research on biological samples, and lymphocytes subpopulation study. All cases presented with motor, behavioural, and cognitive disorders. Visual, sensitive, and cerebellar deficits developed in three cases. MRI revealed widespread progressiv…

Radiographic Features with Pathological Correlation in Cerebral Amyloid Inflammatory Vasculopathy A Case Report

2014

Cerebral Amyloid Angiopathy (CAA) is characterized by deposit of β-amyloid protein in the cortical and leptomeningeal arteries. It tends to increase in prevalence with advancing age and seems to have slight predilection for temporal, parietal and occipital lobes. It has recently been identified an inflammatory form of this angiophaty. This report describes a case presenting as an inflammatory vasculitis-perivasculitis form successfully treated with steroids and discuss about typical features and findings of this condition.

Immunological Markers for PML Prediction in MS Patients Treated with Natalizumab

2015

International audience; Natalizumab (NTZ), a monoclonal antibody recognizing the alpha4 integrin chain, has been approved for the treatment of active multiple sclerosis, but expose to the onset of a rare side effect, progressive multifocal leukoencephalopathy (PML). Estimating the individual risk of PML in NTZ-treated patients is a major challenge, and therapeutic strategies are mainly guided by the overall PML risk assessed by identified risk factors: JC virus (JCV) seropositivity, treatment duration (with peak incidence after 24 months), and the previous use of immunosuppressive therapies. Given that this stratification does not yet allow a precise individual prediction of PML, other pred…

Angiotensin converting enzyme gene polimorfism and central obesity: relationship with blood pressure and left ventricular structure and function

2001

CT and MR Imaging of Non-neoplastic Intracranial Masses

1989

Many intracranial mass lesions of non-neoplastic origin present CT and MR features similar or identical to those of true neoplasms. In many cases a definitive diagnosis cannot be made from imaging findings alone, and misinterpretation is possible even when the history and clinical findings are considered. Yet an accurate preoperative diagnosis is an essential prerequisite for selecting candidates for a neurosurgical operation and planning the procedure. In some cases the full range of neuroradiologic techniques may have to be applied and evaluated in the context of clinical findings before the physician can accurately classify the disease and draw appropriate therapeutic conclusions.

Natalizumab therapy of multiple sclerosis: recommendations of the Multiple Sclerosis Study Group-Italian Neurological Society

2011

Three years after the introduction of natalizumab (NA) therapy for the second line treatment of relapsing-remitting multiple sclerosis (MS), Italian MS centers critically reviewed the scientific literature and their own clinical experience. Natalizumab was shown to be highly efficacious in the treatment of MS. However, the risk of progressive multifocal leukoencephalopathy was confirmed and defined better. This article summarizes the MS-SIN Study Group recommendations on the use of NA in MS, with particular reference to the appropriate selection and monitoring of patients as well as to the management of adverse events.

Diastolic dysfunction and central obesity related hypertension: role of trasforming growth factor beta-1

2004

Abstract P-368 Key Words: Diastolic Dysfunction, Obesity Related Hypertension, Trasforming Growth Factor beta-1

Standard Therapeutic Approach and New Therapies

2015

The traditional approach to therapy of Crohn’s disease has been the step-up approach usually represented as a pyramid (Fig. 7.1) where, progressing from mild to severe disease, therapeutic choices proceed step by step from less potent drugs at the basement of the pyramid to more potent but also more toxic drugs at the top. The advent of biological therapies and the wider use of immunomodulators, together with the opportunity to achieve ambitious treatment goals and possibly to modify the course of disease, have led to other approaches such as the accelerated step-up or the top-down approach. This means that immunomodulators and biologics can be used earlier and de-escalated when disease is …